How Severe Is Your Psoriasis?

Medically Reviewed By William C. Lloyd III, MD, FACS
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One of the challenges associated with psoriasis is that it affects people differently. Psoriasis varies among patients including the type of psoriasis, its severity, and the frequency of flares. For example, your psoriasis may flare occasionally, and someone else could deal with frequent episodes. There are five types of psoriasis. 


Facts About Psoriasis

About 80 percent of people with psoriasis have plaque psoriasis, which gets its name from the noticeable patches (or “plaques”) of thick, scaly skin that may be white, silvery or red. These lesions can appear anywhere on the body but most often occur on the elbows, knees, lower back, and scalp.

The remaining 20 percent of people with psoriasis have one of the other types:

  • Guttate psoriasis, with small, drop-shaped marks typically on the torso, arms, legs and scalp
  • Pustular psoriasis, with pus-filled blisters
  • Inverse psoriasis, with red patches in skin folds
  • Erythrodermic psoriasis, with redness and scales often due to a sunburn

Most people have one form of psoriasis their whole lives, but it is possible to start with one type and then have it change, or develop two forms of psoriasis at the same time.
Psoriasis affects men and women equally. Caucasians are more likely to get psoriasis; however, people of other races and ethnic groups are also susceptible. Psoriasis can begin at any age, but usually it occurs for the first time in people between 15 and 30 years old. In fact, about three-quarters of people with psoriasis develop it before they turn 40. It can, however, develop between the ages of 50 and 60.

Judging Your Severity

Psoriasis is classified according to three levels of severity. Most people with psoriasis (4 out of 5) have the mild form. This means that your plaques affect less than 3 percent of your body. Your psoriasis is considered moderate if your plaques affect 3 percent to 10 percent of your body and severe if plaques cover 10 percent of your body or more. To estimate the severity of your psoriasis, consider that the surface area of the hand equals about 1 percent of the skin.

Very often your severity determines how your doctor treats your psoriasis. In general, mild psoriasis is treated conservatively, with stronger treatments used for moderate to severe psoriasis. The good news is that there is a broad variety of effective psoriasis therapies available for your psoriasis treatment plan. 

Of course, these general categories don’t necessarily convey the degree of physical or emotional distress that psoriasis can cause. Psoriasis affects people differently. Some people find psoriasis very distressing and it affects every aspect of their lives. Others find it little more than a nuisance.

Your feelings about your psoriasis may depend on the severity of the condition, but they can also be influenced by where you have psoriasis plaques. For instance, you may have “mild” psoriasis, but if the plaques form on your feet, you may find walking difficult. If the lesions appear on your hands, you may be extremely self-conscious about them.

Putting Severity in Perspective

Scientists still don’t know why people develop psoriasis. Ongoing research may unlock the mystery one day. Although psoriasis cannot be cured, sometimes it goes away for weeks, months, or even years at a time. Psoriasis is a life-long disease and it can be severe for some people, but it is important to realize that psoriasis can be managed. There are many ways to treat it, and researchers are hard at work on even more effective treatments.

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  1. Questions and Answers About Psoriasis. National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH. http://www.niams.nih.gov/Health_Info/Psoriasis/default.asp#5
  2. Psoriasis Severity. National Psoriasis Foundation. http://www.psoriasis.org/page.aspx?pid=409
  3. Frequently Asked Questions About Psoriasis. PsoriasisNet, American Academy of Dermatology. http://www.skincarephysicians.com/psoriasisnet/FAQs.html#7
  4. What Psoriasis Looks Like. PsoriasisNet, American Academy of Dermatology. http://www.skincarephysicians.com/psoriasisnet/looks_like.html
  5. What is Psoriasis? PsoriasisNet, American Academy of Dermatology. http://www.skincarephysicians.com/psoriasisnet/whatis.html
Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 May 20
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